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Smith v. Berryhill

United States District Court, W.D. New York

May 23, 2017

LORENE SMITH, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.

          DECISION AND ORDER

          HON. MICHAEL A. TELESCA United States District Judge

         INTRODUCTION

         Represented by counsel, Lorene Smith ("Plaintiff") instituted this action pursuant to Title XVI of the Social Security Act ("the Act"), seeking review of the final decision of the Acting Commissioner of Social Security ("the Commissioner")[1] denying her application for Supplemental Security Income ("SSI"). This Court has jurisdiction over the matter pursuant to 42 U.S.C. §§ 405(g), 1383(c).

         PROCEDURAL STATUS

         Plaintiff protectively filed an application for SSI on November 5, 2012, alleging disability beginning January 6, 1992; this claim was denied initially on February 19, 2013. Plaintiff requested a hearing, which was held before administrative law judge Brian Kane (“the ALJ”) on September 12, 2014. (T.41-83).[2] Plaintiff appeared with her attorney and testified, as did impartial vocational expert Carol G. McManus (“the VE”). The ALJ issued an unfavorable decision on December 22, 2014. The Appeals Council denied Plaintiff's request for review on March 24, 2016, making the ALJ's decision the final decision of the Commissioner. This timely action followed.

         The parties have cross-moved for judgment on the pleadings pursuant to Rule 12(c) of the Federal Rules of Civil Procedure. The Court adopts and incorporates by reference herein the undisputed and comprehensive factual summaries contained in the parties' briefs. The record will be discussed in more detail below as necessary to the resolution of this appeal. For the reasons that follow, the Commissioner's decision is reversed, and the matter is remanded for further administrative proceedings.

         ANALYTICAL FRAMEWORK

         To qualify for disability benefits under 42 U.S.C. § 423(d)(1)(A), a claimant must establish his “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . which has lasted or can be expected to last for a continuous period of not less than twelve months.” Butts v. Barnhart, 388 F.3d 377, 383 (2d Cir. 2004). The Commissioner's regulations set forth a five-step sequential evaluation that the ALJ must follow when evaluating disability claims. See 20 C.F.R. §§ 404.1520, 416.920. In cases where there is medical evidence of drug addiction or alcoholism, the ALJ is required to perform a secondary analysis. Pursuant to 42 U.S.C. § 423(d)(2)(C), even if a claimant qualifies for disability benefits under the five-step analysis, the claimant “shall not be considered disabled . . . if alcoholism or drug addiction would . . . be a contributing factor material to the Commissioner's determination that the individual is disabled”. 42 U.S.C. § 423(d)(2)(C); see also 20 C.F.R. §§ 416.935(a), 404.1535(a). In determining whether a claimant's alcohol or drug abuse is a “material” factor, an ALJ is required to apply the following process codified at 20 C.F.R. §§ 416.935, 404.1535(b):

(1) The key factor we will examine in determining whether drug addiction or alcoholism is a contributing factor material to the determination of disability is whether we would still find you disabled if you stopped using drugs or alcohol.
(2) In making this determination, we will evaluate which of your current physical and mental limitations, upon which we based our current disability determination, would remain if you stopped using drugs or alcohol and then determine whether any or all of your remaining limitations would be disabling.
(i) If we determine that your remaining limitations would not be disabling, we will find that your drug addiction or alcoholism is a contributing factor material to the determination of disability.
(ii) If we determine that your remaining limitations are disabling, you are disabled independent of your drug addiction or alcoholism and we will find that your drug addiction or alcoholism is not a contributing factor material to the determination of disability.

20 C.F.R. §§ 416.935(b), 404.1535(b). “The claimant bears the burden of proving that drug or alcohol addiction was not a contributing factor material to the disability determination.” Newsome v. Astrue, 817 F.Supp.2d 111, 126-27 (E.D.N.Y. 2011) (citing White v. Comm'r of Soc. Sec., 302 F.Supp.2d 170, 173 (W.D.N.Y. 2004); Parra v. Astrue, 481 F.3d 742, 748 (9th Cir. 2007) (internal quotations omitted); Mittlestedt v. Apfel, 204 F.3d 847, 852 (8th Cir. 2000); Doughty v. Apfel, 245 F.3d 1274, 1280 (11th Cir. 2001); Brown v. Apfel, 192 F.3d 492, 498 (5th Cir. 1999)).

         DISCUSSION

         Plaintiff contends that the ALJ's materiality finding was legally erroneous and unsupported by substantial evidence because he failed to first determine her physical impairments with substance and alcohol abuse before assessing which, if any, of her physical impairments would remain if she stopped abusing drugs and alcohol. Plaintiff seeks remand of the case for further administrative proceedings; she does not seek reversal and calculation for payment of benefits. As discussed ...


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